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Featured Thursday, Dec 6 2018

Local clinician welcomes national announcement to help tackle growing obesity and type 2 diabetes epidemic

A local clinician who leads on diabetes has welcomed a recent announcement to offer very low calorie diets to those at risk, as part of the NHS’s action to tackle the growing obesity and type 2 diabetes epidemic.

Speaking outside NHS East Berkshire Clinical Commissioning Group’s (CCGs) offices in King Edward Hospital, Windsor, Dr. Nithya Nanda said that the proposed evidence-based pilot was a step in the right direction.

He said: “Around 80% of obese people end up developing type 2 diabetes due to increasing insulin resistance with time. The proposed evidence-based pilot from NHS England is a step in the right direction after encouraging results from the NHS Diabetes Prevention Program (DPP).

“Achieving diabetes remission with a very low calorie diet can prove attractive to our patient population struggling to manage their sugar, lifestyle and medication treatments.

He added: “We should all embrace the culture of appropriate weight loss to prevent life threatening illnesses and complications due to obesity.”

Dr Nandra’s comments follow Friday’s (30/11) national announcement which said that hundreds of thousands of people will receive NHS help to battle obesity and Type 2 diabetes under radical action set out by Simon Stevens, Chief Executive of NHS England.

Very low calorie diets that have been shown to put Type 2 Diabetes in remission in those recently diagnosed with the condition will be trialled as part of the NHS long term plan, which will increase the focus on prevention as well cure.

This will not just improve the health of patients but also save the NHS money that can be reinvested in frontline care. Currently, the health service in England spends around 10% of its budget on treating diabetes.

The scaling up of the NHS DPP scheme, the first in the world to become available country-wide, comes after it proved even more successful than planned with patients losing on average a kilogram more than expected.

The nine month programme helps people to:
· achieve a healthy weight
· improve overall nutrition
· increase levels of physical activity

Online versions of the DPP, which involve wearable technologies and apps to help those at risk of Type 2 Diabetes, will also be provided for patients who find it difficult to attend sessions because of work or family commitments.

Simon Stevens also announced that very low calorie diets will be piloted by the NHS for the first time, from next year. Patients who will be prescribed a liquid diet of just over 800 calories a day for three months and then a period of follow up support to help achieve remission of their Type 2 diabetes.

This approach will initially be piloted in up to 5,000 people following the Diabetes UK funded DiRECT trial, where almost half of those who went on a very low calorie diet achieved remission of their Type 2 diabetes after one year. A quarter of participants achieved a staggering 15 kg or more weight loss, and of these, 86% put their type 2 diabetes into remission.

A more recent trial of very low calorie diets, DROPLET, has demonstrated similar weight loss in obese individuals.

Simon Stevens said: “The NHS is now going to be ramping up practical action to support hundreds of thousands people avoid obesity-induced heart attacks, strokes, cancers and Type 2 diabetes. The NHS Long Term Plan is going to give people the power and the support to take control of their own lifestyles – so that they can help themselves while also helping the NHS.

“Because what’s good for our waistlines is also good for our wallets, given the huge costs to all of us as taxpayers from these largely preventable illnesses. However this isn’t a battle that the NHS can win on its own. The NHS pound will go further if the food industry also takes action to cut junk calories and added sugar and salt from processed food, TV suppers and fast food takeaways.”

Around nine out of 10 people with diabetes have Type 2, which is closely linked to obesity and can lead to a string of serious illnesses, including 13 types of cancer.
Recent projections also show that the growing number of people with diabetes could result in nearly 39,000 people living with diabetes suffering a heart attack in 2035 and over 50,000 people suffering a stroke.